The economics of HIV/AIDS in low-income countries: the case for prevention.

There are two approaches to reducing the burden of sickness and death associated with HIV/AIDS: treatment and prevention. With limited resources, should the focus be on prevention or treatment? I discuss the range of prevention and treatment alternatives, examine their cost effectiveness, and consider various arguments that have been raised against the use of cost-effectiveness analysis in setting priorities for health. I conclude that promoting AIDS treatment using antiretrovirals in resource-constrained countries comes at a huge cost in terms of avoidable deaths that could be prevented through interventions that would substantially lower the scale of the epidemic. David Canning is Professor of Economics and International Health, Harvard School of Public Health, Harvard University, Boston, Massachusetts. e-mail: [email protected]